Registration: Confronting Systemic Racism
This is a registration page for the upcoming course Confronting Systemic Racism which will commence for 5 weeks beginning on Tuesday, Oct 8th from 6:30 - 8:30 pm in the Back Bay neighborhood of Boston.

This form is step two in the requirement for securing your enrollment in the course. By this point you should have already registered yourself as a participant on the Eventbrite page and/or contacted information@antiracismcollaborative.org if you have a sliding-scale need or to confirm your means of payment.

The form results will remain confidential and are used solely to support access centered work in our teaching facilities and program content. We use these details to create the optimum program for your needs by sharing important information with the facilitators who will be working directly with you.

We are excited for your interest in the course and encourage you to direct any additional questions you may have to information@antiracismcollaborative.org. Please note that this form has been created in advance of our typical enrollment period due to demand and that you will hear from a course organizer closer to the date of the class for your participant resources. Thank you and we look forward to meeting with you soon.

Please follow Anti-Racism Collaborative on Facebook for the most up-to-date events and workshops. (https://www.facebook.com/ARCollab/)
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Email *
Name *
What do you hope to gain from this training experience? (please be specific) *
In addition to this workshop series, what other types of experiences have you had learning about diversity or racial justice? *
It is suggested that this is not your first experience in racial awareness or activism broadly defined.
Do you have a sense about the challenges you face around prejudice or racism? Please describe to the degree that you are comfortable doing so. *
What pronoun do you prefer to identify your gender identity?
While this question is not mandatory, it helps us understand who is attracted to and attending our courses and how to support all learning styles and create as safe a class as possible.
How do you identify generationally?
While this question is not mandatory, it helps us understand who is attracted to and attending our courses and how to support all learning styles and create functioning spaces, as much as possible with our given resources.
How do you identify racially?
While this question is not mandatory, it helps us understand who is attracted to and attending our courses and how to support all learning styles and create functioning spaces, as much as possible with our given resources. Additionally, your answer will help us frame whether or not, or how, we will implement affinity based course work.
How do you identify your class background?
While this question is not mandatory, it helps us understand who is attracted to and attending our courses and how to support all learning styles and create as safe a class as possible.
Will you require any support related to ability differences to access materials or the teaching space that you would like us to be aware of?
While this question is not mandatory, it helps us understand how to support all learning styles, accessibility needs or concerns so we can create as functional a class as possible.
Is there any additional information you would like us to know?
The information in this survey will be used to aid facilitators to address concerns and prepare for participants' needs. If you consent, the content of the survey will also be used to understand the demographics of course participants and to aid us in growing more responsive in our commitment to nuanced and sensitive anti-racism trainings. Specify your consent by checking the box below. *
Required
How do you feel about providing film reactions or quotes (anonymous or otherwise) to describe our workshops to future participants? *
Details are subject to your comfort level and would require a release.
If you would like to be kept updated about future training please respond based on your preference. *
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